Isolated duodenal perforation at D4 following blunt abdominal trauma

Omondi, Marilynn; Irene, Mutua; Dan, Kiptoon

doi:10.1016/j.ijscr.2020.06.076

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…There are multiple mechanisms of injury, such as direct force between the spine and the anterior abdominal wall causing tearing the mesentery, a shearing force by acceleration and deceleration, an increase in intraluminal pressure [ [8] , [9] , [10] ]. Because the duodenum has a retroperitoneal location, it provides a degree of protection [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Case report emphasize pearls of duodenal perforation

Luna-Álvarez,

Navarro-Pimiento,

Alarcón-Carvajal

et al. 2023

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Case report emphasize pearls of duodenal perforation

Luna-Álvarez,

Navarro-Pimiento,

Alarcón-Carvajal

et al. 2023

International Journal of Surgery Case Reports

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“…Isolated injury to the duodenum was observed to be only 1.45%. [3][4][5] The risk of associated injuries to the main pancreatic duct, common bile duct, portal vein, abdominal aorta, inferior venacava and superior mesenteric vessels, as well as increased risk of spleen or diaphragmatic rupture makes duodenal injury potentially which were not evident in our patient. Theoretically, duodenal perforation should be associated with amylase or other digestive enzyme leakage but due to its low specificity, serial assessment of the serum amylase would be time consuming and inconclusive.…”

Section: Discussionmentioning

confidence: 99%

“…The lacerated edges were freshened and repaired in a single layer using interrupted 3-0 polyglactin suture and the patient had a decent postoperative period. 3 Celik A et al (2010) published case series and literature review on the management of isolated duodenal rupture due to blunt abdominal trauma in which he discussed about three cases with grade III to grade IV injuries in the third part of duodenum. One of the patients underwent Heineke-Mikulicz pyloroplasty like primary repair, second and the third patients underwent primary repair and pyloric exclusion with gastrojejunostomy.…”

Section: Gradementioning

confidence: 99%

Isolated perforation of fourth part of Duodenum following Blunt Abdominal Trauma

Maharjan¹,

Bharti²,

Khadka³

et al. 2022

J. Nepalgunj Med. College

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Introduction: Isolated duodenal injuries are rare in blunt abdominal trauma. These present a significant challenge for management because of the associated injuries and its difficult anatomical accessibility. Case presentation: A 20years male presented to the Emergency department following a bike accident sustaining injury over face, chest and abdomen, 6hours after the incident. His vitals were unstable so he was resuscitated and admitted in Intensive Care Unit. He had generalized abdominal tenderness without rigidity. Contrast enhanced computed tomography of abdomen and pelvis was suggestive of hollow viscus perforation. He underwent exploratory laparotomy and primary repair for isolated perforation at fourth part of duodenum. He was discharged on his ninth postoperative day. Conclusion: Rare injuries following blunt abdominal trauma should be considered and early intervention is necessary.

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“…The duodenum is fixed to the diaphragm with the ligament of Treitz (at the duodenojejunal flexure). This increases the risk of perforation during blunt abdominal trauma due to compression of the duodenum against the lumbar vertebrae [ 3 ]. The patient may present with mild abdominal pain.…”

Section: Introductionmentioning

confidence: 99%

An Isolated Perforation of the Fourth Part of the Duodenum Following Blunt Abdominal Trauma: A Case Report

Kaur¹,

Kaur²,

Singh³

et al. 2023

Cureus

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An isolated perforation of the duodenum is rare in cases of blunt abdominal trauma, and diagnosis is often delayed due to subtle clinical signs. We present the case of a 13-year-old male patient who presented to the hospital with an alleged history of being run over in the abdomen by a vehicle and a complaint of severe abdominal pain. Radiography of the abdomen in the standing position showed air under the diaphragm, and ultrasonography revealed free fluid in the pelvic and peritoneal cavities, clinching the diagnosis of hollow viscus perforation. The patient was resuscitated and underwent an exploratory laparotomy under general anesthesia. On exploration, no perforation was found in the intraperitoneal organs. The retroperitoneum was opened, and the Cattell-Braasch maneuver was used to approach the duodenum. A single perforation was discovered in the fourth part, and a modified graham patch repair was done. As soon as the patient's bowel sounds returned, a low-fat diet was started through a nasojejunal tube placed distal to the perforation site. The patient was discharged in good condition and is doing well with regular follow-ups. This case emphasizes the need for a high index of suspicion for gut perforation of both intra-and retroperitoneal organs after blunt trauma. This will help in early diagnosis and timely management to reduce perforationassociated mortality. Damage control surgery, with primary closure of the perforation, is well-suited and preferred in an emergency and resource-limited setting.

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Isolated duodenal perforation at D4 following blunt abdominal trauma

Cited by 4 publications

References 14 publications

Case report emphasize pearls of duodenal perforation

Case report emphasize pearls of duodenal perforation

Isolated perforation of fourth part of Duodenum following Blunt Abdominal Trauma

An Isolated Perforation of the Fourth Part of the Duodenum Following Blunt Abdominal Trauma: A Case Report

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